Shoulder Replacement for the Young and Active: Is the “Ream and Run” Right for You?
With advances in surgical techniques and shoulder implants, we are now seeing shoulder replacement surgeries providing up to 20 years or more of functional life and pain relief. However, one area where we continue to face challenges is the durability of the artificial glenoid, or shoulder socket. Currently, shoulder sockets are made of plastic and can wear, loosen, or even break over time. While it is impossible to predict how long a plastic socket implant will last, one thing is clear. If and when it does fail, the patient will experience shoulder pain and will most likely require revision surgery.
Younger patients with shoulder arthritis tend to face a higher risk of implant failure based on the additional years they are expected to live and the stress their active lifestyles place on their implant throughout those years. As an alternative to traditional shoulder surgery, young and healthy patients now have the option to avoid plastic socket implantation altogether through a unique procedure known as a “Ream and Run.”
Pioneered by renowned shoulder surgeon, Frederick A Matsen, III, MD of the University of Washington in Seattle, the Ream and Run is a technically exacting procedure that differs from a typical shoulder replacement surgery in that the surgeon reshapes, reorients, and smoothes the surface of the patient’s socket rather than replacing it. The surgeon then removes the damaged cartilage from the shoulder socket so that a metal ball with a stem, which replaces the humeral ball, fits inside the arm bone (humerus).
Rehabilitative exercises are begun immediately after surgery with experienced shoulder therapists. In order to ensure proper healing, the patient must frequently stretch, exercise, and attain and maintain the range of motion achieved at surgery. The recovery following a Ream and Run is typically challenging because it can be painful and lengthy. However, those who have gone through it say that it is worth it, but you must prepare yourself mentally for the journey and be willing to put in the work. The Ream and Run procedure is not for everyone. The ideal patient is healthy and active. He or she should only be considered when willing to put the required amount of time and effort into the rehabilitation process.
Patient selection for a Ream and Run can often determine the outcome of the surgery. It is imperative that your surgeon has the knowledge and experience to operate on only the most qualified candidates. Dr. Moby Parsons of Seacoast Orthopedics & Sports Medicine trained under Dr. Matsen at the University of Washington during the time it was being perfected and validated and therefore has firsthand experience with patient selection criteria, as well as other variables that can impact the outcomes. Dr. Parsons currently performs the Ream and Run procedure in the Seacoast area of New Hampshire.
While not ideal for all shoulder replacement candidates, Dr. Parsons believes the Ream and Run is perhaps the best alternative to a standard total shoulder replacement in terms of restoring comfort and function in younger patients who suffer from moderate to severe shoulder arthritis and are seeking a long-lasting solution. To learn more about the Ream and Run procedure and find out if it is right for you, call us at (603) 742-2007 to schedule an appointment with Dr. Parsons.
Read the article about Dr. Parsons and the Ream and Run procedure that was published in Fosters Daily Democrat.